Medical Aficionado

I’m encouraged to see a growing interest in treating and at least understanding autism amongst hospitalists. These hospital medicine physicians are stretched pretty thin as is, what with having to care for all types of hospitalized patients. So it’s understandable if their clinical attention may not have the mental room for high levels of engagement with autistic patients. In particular I’m hearing pediatric hospitalist are taking charge and swallowing the fact that autism rates are on the rise and treating these patients does require much more time and training. Randall Children’s Hospital in Portland states clearly in their job posting positions that pediatric hospitalists will “see a broad range of developmental disorders including autism and intellectual disabilities.” Many other hospitals appear to have at least one hospitalist as the “go to guy” to meet with autistic patients. And the other resident hospital medicine professionals are showing great interest in picking the brain of these local leaders. Can we say job security? 🙂

Ref:
http://www.hospitalmedicine.org/AM/Template.cfm?Section=Hospitalist_Definition&Template=/CM/HTMLDisplay.cfm&ContentID=24835

http://www.allhospitalistpositions.com/

http://www.legacyhealth.org/employment

The newest statistics reveal 1 in 88 or just over 1% of children are being born with an autistic spectrum disorder. What other medical disorder has this high of an occurrence yet is still so fundamentally misunderstood? I sure can’t think of one.

My favorite related organization – Autism Speaks – works hard and works smart towards educating and connecting families with autism resources. This organization has grown extremely quickly in the past several years and they do so much good in the world. Their fundraising is fueled by thousands of regular individuals creating ingenious campaigns to spread awareness to those around them. They truly have grassroots growth (a term that’s been stained by politics). It’s a rare opportunity to be part of something truly awesome, where the numbers are increasing by the day.

“A simple brain trace can identify autism in children as young as two years old, scientists believe.

A US team at Boston Children’s Hospital say EEG traces, which record electrical brain activity using scalp electrodes, could offer a diagnostic test for this complex condition.

EEG clearly distinguished children with autism from other peers in a trial involving nearly 1,000 children.”

Ref: http://www.bbc.co.uk/news/health-18577327

I find it difficult to see a great need for this. Child neurologists and even pediatricians can detect autistic behaviors in children that young within a few minutes of meeting them. Other family doctors could be trained to do so as well. I feel like this is a public awareness issue that technology is trying to solve. At least it’s EEG, so there is no radiation emitted.

Is this just a stepping stone towards detecting autism in the fetus? Bring on the ethics debate.

Why is autism considered a disease and not merely a condition of looking at and experiencing the world differently? The responsibilities of modern society have forced us to coin the terms “high functioning” and “low functioning” autism. These two extremes represent the endpoints on a spectrum defined by how well a person functions in society and handles personal responsibilities. While this may be necessary in order to ensure care and safety as well as provide a fair basis of accountability to laws (for example, what constitutes disorderly conduct for a low functioning autistic person?), it should not justify such a strong pathological insinuation that these individuals must be labeled “diseased”.

It’s my personal belief that our failure or inability to feel comfortable with celebrating autism is partially the fault of intelligence testing. IQ testing in general is tough because no one can define what intelligence is to begin with. So how do you test that which you cannot define? What would Mozart’s IQ have been? How about Shakespeare’s?  If my IQ tested higher than J.K. Rowling’s does that mean I could potentially be a better writer than her? Of course not, such an interpretation is so ridiculous yet unfortunately not so distance from public thought. We’ve glorified an integer, summed up all human potential into an easily boasted rank. Okay, enough of this mini-rant. Now then, autistic people in general do not test well. In order to begin seeing their mental capacity in a new light, we need to “test” them at young ages in ways that can reveal multiple types of intelligence. So what types of intelligence are there? For that I’ll leave you with a direct text from ‘Embracing the Wide Sky’:

Linguistic intelligence: involving both spoken and written language, the ability to learn languages, and the capacity to use language to achieve certain goals. Examples: writers, poets, lawyers, and speakers.

Logical-mathematical intelligence: the capacity to analyze problems, perform mathematical operations, and investigate issues scientifically. Examples: scientists, engineers, and mathematicians.

Musical intelligence: skill in the performance, composition, and appreciation of musical patterns. Musicians of all kinds are obvious examples of this intelligence.

Bodily-kinesthetic intelligence: using parts or the whole of one’s body to solve problems. Examples: athletes, actors, and dancers.

Spatial intelligence: includes having a very good sense of direction, as well as the ability to visualize and mentally manipulate objects. Examples: artists, architects, and engineers.

Interpersonal intelligence: the capacity to understand the feelings, intentions, and motivations of other people. Examples: salespeople, politicians, and therapists.

Intrapersonal intelligence: the ability to understand oneself, one’s feelings, goals, and motivations. Examples: philosophers, psychologists, and theologians.

Naturalistic intelligence: the ability to draw upon certain features of the environment, to grow and nurture new things, and to have a facility for interacting with animals. Examples: farmers, gardeners, and conservationists.

What do BitTorrent and Pokémon have in common? They were both created by individuals with autism spectrum disorder. An uncompassionate stereotype exists which pigeonholes autistic people as disabled, antisocial, and obsessed with exclusively trivial, impractical interests. But in reality, there is no typical form of autism. Every autistic person has different mental strengths, limitations, and desires for their own personal and professional development.

It’s believed that Autism’s close association with Savant syndrome, in part, helps keep this stereotype alive. Savants, another severely misunderstood group, are individuals with a developmental disorder which is usually, but not always, autism. But these individuals also possess rare abilities related to their condition in one or more fields. Thomas Fuller, an enslaved African, from the 18th century was able to “comprehend scarcely anything, theoretical or practical, more complex than counting” according to medical literature from 1789. Fuller was once tested with a question “How many seconds has a man lived at 70 years, 17 days and 12 hours old?” After 90 seconds, Fuller answered 2,210,500,800. One of the men in the room worked out the problem on paper and told Fuller that his was incorrect, too large. Fuller quickly informed the man that he must of forgotten to include leap years. After the leap years were added, Fuller was confirmed to be correct.

A century later the word “savant” was coined to describe individuals who display extraordinary mental abilities alongside a spectrum of developmental problems. Given the wide of array of possible mental abilities coupled with the vast array of possible development problems, you can see how both autism and savantism are weighted down by public speculation and misunderstanding. Thankfully, we are making a great many strides forward in both instruction and awareness thanks to educators like Daniel Tammet. In Daniel we can readily see an example of an autistic savant who is fully capable of intricate human emotions and of making meaningfully contributions to society.

Meet Daniel Tammet, a British writer and educator who possesses an extremely rare form of high-functioning autism. Daniel suffered a life-threatening seizure at a young age that resulted in a mixture of his brain functions – parts of the brain that normally function separately, for him became intertwined and codependent. So what is the observable result of this? One of Daniel’s most publicized feats is memorizing Pi to over 22,000 decimal places in just a couple of weeks. It took him 5 hours to recite the full length of the digits he stored in his memory and he never made even one mistake.

I’m currently reading his latest book ‘Embracing the Wide Sky’ which has successfully helped me locate some of my own deep seated presuppositions about learning and the natural world in general. Daniel sincerely believes his mental gifts are not reserved only for savants and even prefers that he not be “removed from humanity” by being viewed in such a way. He devotes a great deal of time to expressing his admiration of a child’s brain, believing that the key to unlocking our own brain’s potential is through a long process of unlearning and deprogramming.

Please watch Daniel’s five minute introduction to his book: http://www.youtube.com/watch?v=fIDMCC2SJek

I will post updates after I finish reading this great work.

-Ramesh